I mean war always has been a part of our life since the first civilizations was established. I’m sure “shellshock” wasn’t only caused by artilery shots.
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A lot of people are pointing out the extended nature of the combat and the physical damage from shelling.
There is another key aspect which is how visible the danger is. In all previous wars you would see the person who was trying to kill you. The guns weren’t really capable of supporting snipers and artillery didn’t really exist except for attacking buildings. So you would see your enemy, know they were going to try and kill you, and then feel the stress. When there was no event in sight then you were safe.
In WWI, with artillery and more long range guns, you could be just minding your business eating lunch and then be blown to bits. When going over the top you wouldn’t know where the dangers were until a hidden machine gun opened fire or you stepped in a mine.
A part of how PTSD works is that your brain is trying to figure out how to keep you safe. If there are clear signs that danger is about to happen, such as someone pulls a gun on you, then your defensive instincts kick in and we consider this healthy. If the harm you experienced didn’t have any clear indicators then your mind will try to find some and will come up with multiple false positives. This is what is meant by triggers. The more unexpected and frequent the negative outcome was, the more things your brain will fixate on as potential dangers and the more of your life you will spend in terror mode watching out for the super bad thing you’re mind wants to avoid at all costs.
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